Reduced Ability to Choose:

• Most health care plans (Insurance, PPO, HMO, etc.) offer little coverage and/or reimbursement for mental health services. Most HMOs and PPOs require “preauthorization” before you can receive services. This means you must call the company and justify why you are seeking therapeutic services to receive reimbursement. The insurance representative, who may or may not be a mental health professional, will decide whether services will be allowed. If authorization is given, you are often restricted to seeing the providers on the insurance company’s list. Reimbursement is reduced if you choose someone who is not on the contracted list; consequently, your choice of providers is often significantly restricted.

Pre-Authorization and Reduced Confidentiality:

• Insurance will typically authorize several therapy sessions at a time. When these sessions are finished, your therapist must justify the need for continued services. Sometimes additional sessions are not authorized, leading to an abrupt end of the therapeutic relationship, even if therapeutic goals are not completely met. Your insurance company may require additional information to approve or justify a continuation of services. Confidentiality cannot be assured or guaranteed when an insurance company requires information to approve continued services. Even if the therapist justifies the need for ongoing services, your insurance company may decline services. Your insurance company dictates if treatment will or will not be covered. Note: Personal information might be added to national medical information data banks regarding treatment.

Reimbursement Eligibility:

• Some psychiatric diagnoses are not eligible for reimbursement. 

Enhanced Quality of Care and Other Advantages:

• You have more flexibility with your care, including choosing your therapist, length of treatment, types of therapy received, etc.